Aging science is incredibly hard and complex. However, I believe we are poised for stunning breakthroughs in the next 40 years, driven by three tailwinds for aging science.
First, consider the aging population globally, which will bring increasingly intense pressure, interest and resources to find solutions. The UN predicts that the over-65 population will more than double from 2019 to 2050, to 1.3 billion people [1]. The UN also predicts the over-80 population will nearly triple from 2019 to 2050, to 426 million. Aging people will push for progress against age-related disease. They will vote for more funding. They will donate their money and effort to help. This is already happening. Witness the rapid growth of new aging science centers and labs, and startups working on longevity. It's not hard to imagine 10x the number of people working on aging science in 2030 vs. a few decades ago.
Second, consider how much foundational work has been done in the last few decades to understand aging at the molecular, cellular, tissue and organismal levels. 1000s upon 1000s of studies to understand the hallmarks of aging, the mechanisms of age-related diseases and the success of countless interventions. This base of knowledge means we can stand on the shoulders of giants. For example, in the last 30 years, we now understand what senescent cells are, how they impact aging and how to remove them (via senolytics). These could be FDA-approved medicines in the next decade. As another example, we identified that "parabiosis" (blood-sharing) rejuvenates old mice with young mice blood, and that the mechanism is likely clearing out molecular "noise" [2]. These benefits appear to come from plasma exchange that doesn't even require any "young blood". Once again, this could be an FDA-approved therapy in the next decade.
Third, consider a few fundamental breakthroughs, including genomics, cellular reprogramming, CRISPR and artificial intelligence. These are general purpose technologies that are creating revolutions in biological research and beyond. The progress in single-cell genomics is leading to exponential growth in data and insights into our cells. The ability to reprogram cells, originally via "Yamanaka Factors," is leading to a flurry of new research and heavily funded startups. For example, we can now program astrocytes into functional dopamine neurons, and even reverse a model of mouse Parkinson's [3]. CRISPR drastically simplifies gene editing, which is a boon for research and for new treatments. The progress in deep learning even in the last 5 years is night and day. These breakthroughs are being used together, and are building on each other. Labs and startups are using genomics, reprogramming and AI together to do things that would have been impossible 5 years ago.
Together, these tailwinds set the table for what I believe will be astounding progress in aging science in the next 40 years.
For example, let's do a quick thought experiment: imagine that going forward, we find just one new thing that extends lifespan/healthspan by 10 years in each decade. In four decades, your life expectancy could be 40 years longer than you thought.
[1] United Nations Department of Economic Social Affairs. World population prospects 2019: highlights. New York: United Nations Department of Economic Social Affairs; 2019.
[2] Kim, D., Kiprov, D.D., Luellen, C. et al. Old plasma dilution reduces human biological age: a clinical study. GeroScience (2022). https://doi.org/10.1007/s11357-022-00645-w
[3] Qian, H., Kang, X., Hu, J. et al. Reversing a model of Parkinson’s disease with in situ converted nigral neurons. Nature 582, 550–556 (2020). https://doi.org/10.1038/s41586-020-2388-4
